Inhoudsopgave
1. Inleiding..................................................................................................................................................... 5
1.1 Definitie van slechtziendheid..........................................................................................................................5
1.1.1 Verschil slechtziend en blind...................................................................................................................5
1.1.2 Wettelijk blind/legally blind....................................................................................................................5
1.2 Denken – durven – doen – doorzetten............................................................................................................5
1.2.1 Denken....................................................................................................................................................5
1.2.2 Durven....................................................................................................................................................7
1.2.3 Doen........................................................................................................................................................8
1.2.4 Doorzetten............................................................................................................................................10
1.3 Quizvragen...................................................................................................................................................10
2. Gezichtshulpmiddelen klassen.................................................................................................................. 11
2.1 Klasse............................................................................................................................................................11
3. Galileï versus Kepler................................................................................................................................. 12
4. Oorzaken van slechtziendheid.................................................................................................................. 13
4.1 Inleiding........................................................................................................................................................13
4.2 Aandoeningen zonder verlies van het gezichtsveld......................................................................................13
4.3 Aandoeningen met verlies van het centrale gezichtsveld............................................................................13
4.4 Aandoeningen met verlies van het perifere gezichtsveld.............................................................................14
4.5 Cornea afwijkingen......................................................................................................................................14
4.5.1 Troebeling van de cornea......................................................................................................................14
4.5.2 Dystrofie van de cornea........................................................................................................................14
4.5.3 Sterk astigmatisme...............................................................................................................................14
4.5.4 Keratoconus..........................................................................................................................................14
4.5.5 Te grote cornea.....................................................................................................................................14
4.5.6 Te kleine cornea....................................................................................................................................14
4.6 Pupilafwijkingen...........................................................................................................................................15
4.6.1 Aniridie..................................................................................................................................................15
4.6.2 Coloboma..............................................................................................................................................15
4.7 Afwijkingen van de kristallens......................................................................................................................15
4.7.1 Cataract.................................................................................................................................................15
4.7.2 Luxatie van de kristallens......................................................................................................................15
4.8 Andere afwikingen/aandoeningen...............................................................................................................16
4.8.1 Hoge myopie.........................................................................................................................................16
4.8.2 Albinisme..............................................................................................................................................16
4.8.3 Achromatopsie......................................................................................................................................16
4.8.4 Coloboma..............................................................................................................................................17
4.8.5 Chorioretinitis (congenitale toxoplasmose)..........................................................................................17
4.8.6 Nervus opticus aandoeningen..............................................................................................................17
4.8.7 Dystrofie................................................................................................................................................18
4.8.8 Retinitis pigementosa...........................................................................................................................18
4.8.9 Glaucoom..............................................................................................................................................18
4.9 Maculaire degeneratie (LMD)......................................................................................................................19
4.10 RIZIV aandoeningen...................................................................................................................................20
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,5. Blauw licht bescherming voor gezonde en zieke ogen...............................................................................21
5.1 Inleiding........................................................................................................................................................21
5.1.1 Filter vs normale tint.............................................................................................................................21
5.1.2 Elektromagetische straling....................................................................................................................21
5.1.3 Het zichtbare licht.................................................................................................................................21
5.2 Contrast........................................................................................................................................................22
5.2.1 Detectie op het netvlies........................................................................................................................22
5.2.2 Normaal contrast gevoeligheid?...........................................................................................................22
5.3 Comfort........................................................................................................................................................22
5.3.1 Comfort voor gezonde en zieke ogen...................................................................................................22
5.3.2 Enkele functionele theorieen...............................................................................................................22
5.4 Bescherming.................................................................................................................................................23
5.4.1 UV licht en blauw licht zijn potentieel schadelijk.................................................................................23
5.4.2 Natuurlijke bescherming in het oog.....................................................................................................23
5.4.3 Blauw licht en het circadiaans ritme.....................................................................................................23
5.5 Filter kleuren.................................................................................................................................................23
5.5.1 Filter 400...............................................................................................................................................23
5.5.2 ML filter C1............................................................................................................................................23
5.5.3 Filter 450...............................................................................................................................................24
5.5.4 Filter 500...............................................................................................................................................24
5.5.5 Filter 511...............................................................................................................................................24
5.5.6 Filter 527...............................................................................................................................................24
5.5.7 Filter 550...............................................................................................................................................24
5.5.8 ML filter 585..........................................................................................................................................25
5.5.9 Filter LLR...............................................................................................................................................25
5.5.10 Overzicht filters/dito alle merken.......................................................................................................25
5.5.11 Mogelijkheden....................................................................................................................................25
5.5.12 AMD comfort......................................................................................................................................25
5.5.13 Praktische tips.....................................................................................................................................26
5.5.14 Polarisatie...........................................................................................................................................26
5.5.15 Complementaire kleuren....................................................................................................................26
6. E-scoop.................................................................................................................................................... 27
6.1 5 werkende elementen:................................................................................................................................27
6.2 Werking E-scoop...........................................................................................................................................28
6.3 Resultaat voor de client................................................................................................................................28
6.4 Onderzoek Oogziekenhuis en Vumc (N=144) visus......................................................................................29
6.5 Onderzoek Oogziekenhuis en Vumc (N=144) resultaten voor de client......................................................29
6.6 Test methode, flipper....................................................................................................................................29
7. Vergroting................................................................................................................................................ 30
7.1 Netvliesbeeldvergroting...............................................................................................................................30
7.2 Hoe een groter netvliesbeeld creeren?........................................................................................................30
7.2.1 Relatieve beeldvergroting.....................................................................................................................30
7.2.2 Hoekvergroting.....................................................................................................................................30
7.2.3 Relatieve afstandsvergroting................................................................................................................30
7.2.4 Vergroting door afstand........................................................................................................................31
7.2.5 Combinatie van vergrotingen...............................................................................................................31
7.2.6 Opgepast...............................................................................................................................................31
7.2.7 Korte samenvatting...............................................................................................................................31
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,8. Telescopische systemen............................................................................................................................ 32
8.1 MLVIDI..........................................................................................................................................................32
8.2 Netvliesbeeld vergroting..............................................................................................................................32
8.3 Stabiel zicht..................................................................................................................................................32
8.4 ML Vidi..........................................................................................................................................................32
8.5 Bonnet lens om van werkafstand te wisselen..............................................................................................33
8.6 MLFOCUS......................................................................................................................................................33
8.6.1 Gemakkelijk her focussen.....................................................................................................................33
8.7 MLCOMBI.....................................................................................................................................................33
8.7.1 Gezichtsveld..........................................................................................................................................34
8.8 Stabiel zicht – steady vision..........................................................................................................................34
8.9 ML Aplanat/MLA2........................................................................................................................................34
8.9.1 ML Aplanat............................................................................................................................................34
8.9.2 MLA2.....................................................................................................................................................34
9. The daylight company LTD........................................................................................................................ 35
9.1 Soorten lichtbronnen....................................................................................................................................35
9.2 Voordelen LED..............................................................................................................................................35
9.3 Licht kleur/temperatuur (°Kelvin).................................................................................................................35
9.4 Wat is lumen?...............................................................................................................................................36
9.5 Wat is Lux (lx) (lichtsterkte)?........................................................................................................................36
9.6 Lumen versus lux..........................................................................................................................................36
9.7 Licht spreiding met betrekking tot low vision..............................................................................................37
10. Klinische low vision screening................................................................................................................. 38
10.1 Screening nabij...........................................................................................................................................38
10.2 Screening ver..............................................................................................................................................38
11. Praktische aanpassing van vergrotende hulpmiddelen............................................................................39
11.1 Screening....................................................................................................................................................39
11.2 Objectieve refractiemeting.........................................................................................................................39
11.3 Bepalen van de best mogelijke ‘brilcorrectie’............................................................................................39
11.4 Bepalen van het hulpmiddel voor de verte................................................................................................40
11.5 Bepalen van het hulpmiddel voor nabij......................................................................................................40
11.6 Aanpassing van Low Vision hulpmiddel.....................................................................................................40
12. Vollegorde low vision onderzoek............................................................................................................ 42
13. Low vision bij slechtziende kinderen....................................................................................................... 43
14. Casuïstiek............................................................................................................................................... 44
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1. Inleiding..................................................................................................................................................... 5
1.1 Definitie van slechtziendheid..........................................................................................................................5
1.1.1 Verschil slechtziend en blind...................................................................................................................5
1.1.2 Wettelijk blind/legally blind....................................................................................................................5
1.2 Denken – durven – doen – doorzetten............................................................................................................5
1.2.1 Denken....................................................................................................................................................5
1.2.2 Durven....................................................................................................................................................7
1.2.3 Doen........................................................................................................................................................8
1.2.4 Doorzetten............................................................................................................................................10
1.3 Quizvragen...................................................................................................................................................10
2. Gezichtshulpmiddelen klassen.................................................................................................................. 11
2.1 Klasse............................................................................................................................................................11
3. Galileï versus Kepler................................................................................................................................. 12
4. Oorzaken van slechtziendheid.................................................................................................................. 13
4.1 Inleiding........................................................................................................................................................13
4.2 Aandoeningen zonder verlies van het gezichtsveld......................................................................................13
4.3 Aandoeningen met verlies van het centrale gezichtsveld............................................................................13
4.4 Aandoeningen met verlies van het perifere gezichtsveld.............................................................................14
4.5 Cornea afwijkingen......................................................................................................................................14
4.5.1 Troebeling van de cornea......................................................................................................................14
4.5.2 Dystrofie van de cornea........................................................................................................................14
4.5.3 Sterk astigmatisme...............................................................................................................................14
4.5.4 Keratoconus..........................................................................................................................................14
4.5.5 Te grote cornea.....................................................................................................................................14
4.5.6 Te kleine cornea....................................................................................................................................14
4.6 Pupilafwijkingen...........................................................................................................................................15
4.6.1 Aniridie..................................................................................................................................................15
4.6.2 Coloboma..............................................................................................................................................15
4.7 Afwijkingen van de kristallens......................................................................................................................15
4.7.1 Cataract.................................................................................................................................................15
4.7.2 Luxatie van de kristallens......................................................................................................................15
4.8 Andere afwikingen/aandoeningen...............................................................................................................16
4.8.1 Hoge myopie.........................................................................................................................................16
4.8.2 Albinisme..............................................................................................................................................16
4.8.3 Achromatopsie......................................................................................................................................16
4.8.4 Coloboma..............................................................................................................................................17
4.8.5 Chorioretinitis (congenitale toxoplasmose)..........................................................................................17
4.8.6 Nervus opticus aandoeningen..............................................................................................................17
4.8.7 Dystrofie................................................................................................................................................18
4.8.8 Retinitis pigementosa...........................................................................................................................18
4.8.9 Glaucoom..............................................................................................................................................18
4.9 Maculaire degeneratie (LMD)......................................................................................................................19
4.10 RIZIV aandoeningen...................................................................................................................................20
1
,5. Blauw licht bescherming voor gezonde en zieke ogen...............................................................................21
5.1 Inleiding........................................................................................................................................................21
5.1.1 Filter vs normale tint.............................................................................................................................21
5.1.2 Elektromagetische straling....................................................................................................................21
5.1.3 Het zichtbare licht.................................................................................................................................21
5.2 Contrast........................................................................................................................................................22
5.2.1 Detectie op het netvlies........................................................................................................................22
5.2.2 Normaal contrast gevoeligheid?...........................................................................................................22
5.3 Comfort........................................................................................................................................................22
5.3.1 Comfort voor gezonde en zieke ogen...................................................................................................22
5.3.2 Enkele functionele theorieen...............................................................................................................22
5.4 Bescherming.................................................................................................................................................23
5.4.1 UV licht en blauw licht zijn potentieel schadelijk.................................................................................23
5.4.2 Natuurlijke bescherming in het oog.....................................................................................................23
5.4.3 Blauw licht en het circadiaans ritme.....................................................................................................23
5.5 Filter kleuren.................................................................................................................................................23
5.5.1 Filter 400...............................................................................................................................................23
5.5.2 ML filter C1............................................................................................................................................23
5.5.3 Filter 450...............................................................................................................................................24
5.5.4 Filter 500...............................................................................................................................................24
5.5.5 Filter 511...............................................................................................................................................24
5.5.6 Filter 527...............................................................................................................................................24
5.5.7 Filter 550...............................................................................................................................................24
5.5.8 ML filter 585..........................................................................................................................................25
5.5.9 Filter LLR...............................................................................................................................................25
5.5.10 Overzicht filters/dito alle merken.......................................................................................................25
5.5.11 Mogelijkheden....................................................................................................................................25
5.5.12 AMD comfort......................................................................................................................................25
5.5.13 Praktische tips.....................................................................................................................................26
5.5.14 Polarisatie...........................................................................................................................................26
5.5.15 Complementaire kleuren....................................................................................................................26
6. E-scoop.................................................................................................................................................... 27
6.1 5 werkende elementen:................................................................................................................................27
6.2 Werking E-scoop...........................................................................................................................................28
6.3 Resultaat voor de client................................................................................................................................28
6.4 Onderzoek Oogziekenhuis en Vumc (N=144) visus......................................................................................29
6.5 Onderzoek Oogziekenhuis en Vumc (N=144) resultaten voor de client......................................................29
6.6 Test methode, flipper....................................................................................................................................29
7. Vergroting................................................................................................................................................ 30
7.1 Netvliesbeeldvergroting...............................................................................................................................30
7.2 Hoe een groter netvliesbeeld creeren?........................................................................................................30
7.2.1 Relatieve beeldvergroting.....................................................................................................................30
7.2.2 Hoekvergroting.....................................................................................................................................30
7.2.3 Relatieve afstandsvergroting................................................................................................................30
7.2.4 Vergroting door afstand........................................................................................................................31
7.2.5 Combinatie van vergrotingen...............................................................................................................31
7.2.6 Opgepast...............................................................................................................................................31
7.2.7 Korte samenvatting...............................................................................................................................31
2
,8. Telescopische systemen............................................................................................................................ 32
8.1 MLVIDI..........................................................................................................................................................32
8.2 Netvliesbeeld vergroting..............................................................................................................................32
8.3 Stabiel zicht..................................................................................................................................................32
8.4 ML Vidi..........................................................................................................................................................32
8.5 Bonnet lens om van werkafstand te wisselen..............................................................................................33
8.6 MLFOCUS......................................................................................................................................................33
8.6.1 Gemakkelijk her focussen.....................................................................................................................33
8.7 MLCOMBI.....................................................................................................................................................33
8.7.1 Gezichtsveld..........................................................................................................................................34
8.8 Stabiel zicht – steady vision..........................................................................................................................34
8.9 ML Aplanat/MLA2........................................................................................................................................34
8.9.1 ML Aplanat............................................................................................................................................34
8.9.2 MLA2.....................................................................................................................................................34
9. The daylight company LTD........................................................................................................................ 35
9.1 Soorten lichtbronnen....................................................................................................................................35
9.2 Voordelen LED..............................................................................................................................................35
9.3 Licht kleur/temperatuur (°Kelvin).................................................................................................................35
9.4 Wat is lumen?...............................................................................................................................................36
9.5 Wat is Lux (lx) (lichtsterkte)?........................................................................................................................36
9.6 Lumen versus lux..........................................................................................................................................36
9.7 Licht spreiding met betrekking tot low vision..............................................................................................37
10. Klinische low vision screening................................................................................................................. 38
10.1 Screening nabij...........................................................................................................................................38
10.2 Screening ver..............................................................................................................................................38
11. Praktische aanpassing van vergrotende hulpmiddelen............................................................................39
11.1 Screening....................................................................................................................................................39
11.2 Objectieve refractiemeting.........................................................................................................................39
11.3 Bepalen van de best mogelijke ‘brilcorrectie’............................................................................................39
11.4 Bepalen van het hulpmiddel voor de verte................................................................................................40
11.5 Bepalen van het hulpmiddel voor nabij......................................................................................................40
11.6 Aanpassing van Low Vision hulpmiddel.....................................................................................................40
12. Vollegorde low vision onderzoek............................................................................................................ 42
13. Low vision bij slechtziende kinderen....................................................................................................... 43
14. Casuïstiek............................................................................................................................................... 44
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